The use, distribution or reproduction in other forums is permitted, provided the original author(s) and the copyright owner(s) are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. So I had a partial thyroidectomy about 7 months ago. It just felt like something was hung in my throat, often times I didn't even realize when I kept clearing my throat until someone asked me if I was ok. You may have some trouble chewing and swallowing after you go home. hope something good happens soon. The .gov means its official. The liquid LT4 also seems to be more active than tablets in the control of TSH even in hypothyroid patients without malabsorption, drug interference, or gastric disorders, leading to the hypothesis that absorption of liquid LT4 is also higher in this cohort (12). Wisdom Tooth Problems: Do You Need Your Impacted Wisdom Teeth Removed? I have the same problem. I had my thyroid removed about 10 days ago. I would like, then, in this week's entry to share with you an update I sent to friends and family last Saturday about what life was like for me in those hours before and after surgery. Despite a remarkable commitment by researchers to find a therapeutic scheme able to predict the exact dose of LT4 to be given to patients after a total thyroidectomy, the attempt to reach the precise dosage failed to reach the target in the totality of the cases. It is FREE! (13) performed a prospective randomized study of 102 patients who underwent total thyroidectomy and radioactive iodine therapy for DTC and were classified as low risk according to the 2009 ATA guidelines. I suppose my message is if your having swallowing trouble post surgery, get yourselves out for a macdonalds milk shake and start there or melt some ice cream if you have some and over the coming days add milk until it gets thinner and thinner until you can drink just ice cold milk - if you haven't yet had your thyroid gland removed and are reading this- don't worry - this doesn't happen to many people but maybe stock up in some ice cream :), I had my thyroid removed Sept. 29 , this year. Al-Dhahri SF, Al-Angari SS, Alharbi J, AlEssa M. Optimal levothyroxine dose in post-total thyroidectomy patients: a prediction model for initial dose titration. The authors found that in patients with strongly suppressed TSH levels, significant changes in symptoms with a tendency toward thyrotoxicosis were reported. The authors concluded that the liquid form of LT4 can be administered directly through the nasogastric tube without the need for an empty stomach and is more easily managed by a nurse. PMC This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). Immediately after waking up in recovery room had feeling of shortness of breath and like I couldn't get a satisfying breath. Furthermore, patients with biochemical incomplete or indeterminate response should maintain a TSH level between 0.1 and 0.5 mU/L, which increases to a level between 0.5 and 2 mU/L in case of comorbidities or advanced age. These papers addressing the liquid form report some promising results also in patients who have undergone thyroidectomy (12, 13). Worse than the voice part is the fact that I cannot swallow liquids very well and am often choking. ***this post is edited by moderator *** *** private e-mails not allowed*** Please read our Terms of Use. I had a total thyroidectomy last week. Copyright 2000-2022 Cancer Survivors Network. I was told that coughing is healthy. . After my second thyroidAfter my second thyroid surgery I noticed I was having to "cough" to clear my throat a lot. (28). This can certainly make eating (and drinking) a lot harder because there is physically lower levels of lubricating saliva present in both the mouth and oesophagus. They compared their formula to the empirical dose of 100 g and to the only weight-based dose calculation (1.6 g kg), finding that 72, 59, and 40% of patients, respectively, achieved the target within 25 g of their proper dose. The articles included in the review reported pathophysiology and diagnostic concerns. Even this formula, when applied retrospectively, did not lead to better results. Papers that reported a scheme to calculate the proper LT4 dose were collected and compared to set up a review exploring limits and drawbacks of LT4 replacement therapy in the wide population of patients who had undergone thyroidectomy. We offer this Site AS IS and without any warranties. After trying to be as self aware as possible I noticed that the mucus in the area he had noticed would only release in two ways 1) gargling with one of the alcohol based listerine products (I tried the alcohol free and it didn't work as well) 2) eating, within the first few bites the mucus would loosen and go down and clog and require forced removal. 2022 Dec 30;12(1):305. doi: 10.3390/jcm12010305. greyzak. I have the same problem,i had tt 2015 and had a RAI treatmrnt after 2 months,those months swallowing is normal,but after a year i had a swollen salivary gland,from then on till now i have a sallowing problem i could not eat steak or any meat,had been to the ENT and they said they cant see any abnormality,i don't know what will be the next test for me,i hope it will back to normal soon .. have read the commits on here you guys scare me. 5ml 2x/day (1 teaspoon). see the surgeon a lot for this issue. I had the same results. Most literature regarding the LT4 dosage deals with the treatment of primary hypothyroidism, whereas a limited number of studies handle the issue of thyroxin replacement after total thyroidectomy. They did this three times during my last surgery and twice in follow up appointments. in a systematic review regarding swallowing disorders after thyroidectomy, concluded that, depending on the possible causes of dysphagia, different types of diagnostic procedures . dr keeps changing my meds. My oncologist seemed to know exactly what I was talking about when I told him and he prescribed: Hydrocodone-Chlorpheniram Suspension liquid. I remember the first long bike ride I did after my TT, and I tried to eat an energy bar while riding. Di Donna V, Santoro MG, de Waure C, Pia Ricciato M, Paragliola RM, Pontecorvi A, et al. Once a stable normal TSH value was achieved using the tablet formulation, the patients were switched to treatment with the soft gel capsule at the same previous dose. Table 1 Now I find it really hard to swallow food, sometimes even trying to drink is not that easy either! Giusti M, Mortara L, Machello N, E Monti E, Pera G, Marenzana M. Utility of a Liquid Formulation of Levo-thyroxine in Differentiated Thyroid Cancer Patients. Do you have any tips on this? When I do get it out, my air way closes so tight I can barely breathe in at all so I just keep choking. Weight Gain and Asthenia Following Thyroidectomy: Current Knowledge from Literature Review. Maybe the endocrinologists need to be on this group to learn our real symptoms. Same hereI just my thyroidectomy last week and am experiencing the same problems. Fallahi et al. By that I mean they are dosed with T4 and T3 as needed to relieve hypo symptoms, without going so far as to create hyper symptoms. Inclusion in an NLM database does not imply endorsement of, or agreement with, This is suspicious for malignancy. I'm glad to know I'm not the only one. On the other hand, advanced age, risk factors, and underlying comorbidities might play an important role against TSH suppression, and the latter should be avoided (14, 15). . Preliminary path. (female) Join Date: Nov 2004. Maybe I'll have answers for many of you too..hoping! over a year ago, Monkeysocks13 LT4 is a medication with a narrow therapeutic index, and its absorption is dependent on gastric pH (1, 6). Giandalia A, Russo GT, Romeo EL, Alibrandi A, Villari P, Mirto AA, et al. It's more strained. Virili C, Stramazzo I, Santaguida MG, Bruno G, Brusca N, Capriello S, et al. Moreover, concomitant ingestion of calcium supplements, ferrous sulfate, proton-pump inhibitors, bile acid sequestrants, and sucralfate might influence LT4 absorption and/or metabolism. - would appreciate reply. Hi clemclem, can you tell us if your thyroid was ablated by RAI or did you undergo a thyroidectomy followed by RAI? Careers, Unable to load your collection due to an error. (7) proposed a formula that takes into consideration both BMI and actual body weight, with optimal results. The liquid formulation is supposed to overcome the food and beverages interference with absorption of LT4 tablets. i hope it is just a post ops thing and will go away. Afterward, Di Donna et al. Oh dear..hoping this gets better..endo said to see the surgeon since its a surgical issueApril 13th I will see him! I've lost over 20kgs and kept it off! We reviewed the current literature available on MEDLINE database, concerning the swallowing disorders appearing after the thyroidectomy. official website and that any information you provide is encrypted I'm not noticing it now. Further, Carhill et al. was retrospectively applied to a cohort of 180 patients, it predicted the eventual euthyroid dose of LT4 to within 20 g for 61% of patients (20). eCollection 2022. 2 Tracheal perforation related to thyroidectomy is usually detected during surgery, and recovery without major complications is possible with . It's definitely not convenient - I'm unable to go out to dinner with family and friends as I need to be close to the bathroom when I eat - my husbands wonderful and knows what I'm going through, so helps me to keep things "discreet"if we have to go to these family functions. Ojomo KA, Schneider DF, Reiher AE, Lai N, Schaefer S, Chen H, et al. undefined will no longer be visible to you including posts, replies, and photos. My surgeon did tell me that I should be good as new in 6 months, so I am only getting started on my recovery, but if I feel this good now, I can only imagine I'll continue to improve! An official website of the United States government. I had a Crycopharengeal Myotomy in 2014. In particular, Olobuwale et al. Federal government websites often end in .gov or .mil. Are you sure you want to block this member? We found no correlation between dysphagia and patients' age, the specimen volume, and patients' body mass index (Spearman's rank correlation coefficient = 0.1, each). Your voice probably will be hoarse, and you may have trouble talking. Do you have allergies? These schemes take into consideration a combination of the following parameters: body weight, age, body surface area (BSA), iron supplementation, mineral supplementation, preoperative TSH concentration, sex, or body mass index (BMI). It's possible there could be some swelling associated with the healing process. sharing sensitive information, make sure youre on a federal The Content on this Site is presented in a summary fashion, and is intended to be used for educational and entertainment purposes only. Long-term outcome of functional post-thyroidectomy voice and swallowing symptoms. (18) included patients who had undergone total thyroidectomy or lobectomy, making their data not homogeneous. Effects of Intraoperative Nerve Monitoring Techniques on Voice and Swallowing Disorders after Uncomplicated Thyroidectomy: Preliminary Report of a Bi-Institutional Prospective Study. over a year ago. This hurts! I had a really productive cough. Your surgeon will tell you when it is time to remove the drain. and resulted as the most accurate method (19). I have a total thyroidectomy three weeks ago. The tape will fall off after a few weeks. By using this Site you agree to the following, By using this Site you agree to the following, Thyroid Information Your Doctor May Not Know, The Best IOL for 2022 RXSight Light Adjusted Lens, Will refractive surgery such as LASIK keep me out of glasses all my life. I was finally diagnosed with muscle paralysis in my throat from the surgery. the contents by NLM or the National Institutes of Health. Cappelli C, Pirola I, Gandossi E, Casella C, Lombardi D, Agosti B, et al. weight gain of 47 pounds and still gaining. The way this can affect other organ systems is that calcium ions are an integral part of correct muscular contraction and relaxation, which can potentially be an explanation as to why swallowing has become such an issue for you both. It is the main treatment for most people with thyroid tumors. I had thyroid surgery in December 2018. Furthermore, Jin et al. I had a total thyroidectomy on Feb. 27th, and although the first few days after surgery were a little rough, I have made steady improvement since then. Could not breath on my own. Successively, other schemes were proposed. Treatment of refractory and severe hypothyroidism with sublingual levothyroxine in liquid formulation, - Liquid LT4 can be administered immediately without the need for an empty stomach. No pain, do not remember ever needing to remove the steri strips, do not remember worrying about the scarring like I am now.. With both surgeries, I Thyroid function related symptoms during levothyroxine monotherapy in athyreotic patients, Undertreated hypothyroidism due to calcium or iron supplementation corrected by oral liquid levothyroxine. due to medications). These complaints are usually related to superior and inferior laryngeal nerves dysfunction, but these can appear even after uncomplicated surgical procedure. 1 Complications occur in only about 3%-5% of patients after thyroidectomy, with tracheal perforation occurring in approximately 0.06% of cases. I think it may have to do with everything in that area getting used to the added scar tissue. Horrible feeling like I was suffocating - did ekg/stata cxr said no hematoma all tests fine . please email me for updates. Both a TT and RAI can cause swallowing issues. produced schemes that take into account age and sex categories, respectively, along with BMI (19, 20) Di Donna etal applied their scheme prospectively to a cohort of 31 patients, achieving euthyroid status at the first follow-up in 68% (19). I couldn't even swallow my saliva. The Economic Impact of Levothyroxine Dose Adjustments: the CONTROL HE Study. Results. Pain not bad. However, patients with normal TSH levels experienced changes in symptoms with a tendency toward hypothyroidism. A literature review was performed focusing on all papers dealing with this topic within the last 15 years. Neck /throat tightness and pressure Total Thyroidectomy 16 . Hi everyone, I had my thyroidectomy on March 4th and I am still having trouble swallowing liquids, especially ones that are thin, like water. Lastly, in patients with mildly suppressed TSH levels and FT3 levels superimposable to the preoperative values, all symptoms remained equivalent to their preoperative levels. Concerning the degree of suppression during follow-up, regardless the initial ATA class risk classification, patients with excellent response to therapy should maintain a TSH level between 0.5 and 2 mU/L, regardless of comorbidities and age. Hence, several schemes are reported in the literature for the proper initial dose of LT4. best dr to see is an ENT wishing you well, after my surgery i ended up in ICU. The ThyCa: Thyroid Cancer Survivors' Association Support Community connects patients, families, friends and caregivers for support and inspiration. For these reasons and because of the low risk of recurrence and death in DTC, ATA recommends a graded algorithm in which the potential benefits of this therapy are carefully weighed against its cardiovascular and skeletal risks (14, 15). Hi. I even went to a second doctor who put me through more tests as she was baffled too. When I have a panic attack coming on my throat feels like it is closing up. A proper selection then becomes of paramount importance (8). Epub 2018 Sep 7. Conclusion: Thanks. ENTER wants me to have injection in my vocal cord to poof it up to close a place where it's seeping in to the windpipe by pushing it over . I had a total thyroidectomy on Feb. 27th, and although the first few days after surgery were a little rough, I have made steady improvement since then. official website and that any information you provide is encrypted ). It is not intended to be and should not be interpreted as medical advice or a diagnosis of any health or fitness problem, condition or disease; or a recommendation for a specific test, doctor, care provider, procedure, treatment plan, product, or course of action. If you have a large goiter or a large cancerous . Predicting thyroxine requirements following total thyroidectomy. You might feel a lump. (33) in 2018 of patients who underwent total thyroidectomy with severe hypothyroidism reported that euthyroidism was progressively restored after sublingual administration of liquid LT4, making this formulation a valid alternative method for acute treatment of severe hypothyroidism. (22) performed a study to identify factors that would predict the LT4 dose after thyroidectomy. Similar associations have also been reported for thyroid-stimulating hormone (TSH) levels in the upper part of the normal reference range (4, 5). Defects in absorption of thyroid hormones are reported in patients with previous gut surgery, celiac disease, lactose intolerance, autoimmune gastritis, or Helicobacter pylori infection (6, 8, 9). investigated the relationship between symptoms and serum TSH and FT3 levels (26). Inadequate dosage may result in hypothyroidism or hyperthyroidism, both involving serious sequelae at several different levels. Have questions about navigating your Inspire support community or need assistance from one of our Inspire Moderators? If your incision was closed with stitches, ask your surgeon when you can shower. I had my right laryngeal nerve removed during a neck dissection. Methods Patients undergoing unilateral thyroidectomy were prospectively enrolled. Thyroidectomy and weight gain - Good stories only PLEASE!! However, you also have to consider the role ofthe thyroid's calcitoninand the parathyroid's parathormone in calcium ion use as well; calcitonin moves serum calcium into the bones, parathormone moves it out of them. The nights were the worst! I'm so sorry to hear of all the post-op problems everyone has had after their thyroid surgery. Most of the methods for monitoring and adjusting thyroid hormone replacement after thyroidectomy for benign disease use LT4 at an empirical dose of approximately 1.6 g/kg, with subsequent changes according to thyroid function test results and assessments of the patients symptoms. Hemithyroidectomy post surgical pain and tightness! As Mike mentioned, the TT can cause issues. Thyroid hormone treatment plays a central role in the postoperative management of DTC. Careers. A thyroidectomy is the surgical removal of all or part of the thyroid. The coughing has just stopped. Any input on my situation is appreciated. Are you sure you want to block this member? i would presume you're both on synthroid or something similar, and perhaps (hopefully) calcitonin therapy. Keep track of the amount of fluid you empty each time. HHS Vulnerability Disclosure, Help Results: The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest. It has worked really well for me. The Annual International Thyroid Cancer Survivors' Conference and Regional Workshops, Papillary and follicular thyroid cancer (differentiated), Multiple endocrine neoplasia type 2 (MEN2), Mental challenges of living with thyroid cancer, ThyCa fundraising and thyroid cancer research grants. Unauthorized use of these marks is strictly prohibited. For most people, these problems get better within 3 to 4 months, but it can take as long as a year. contued as i was taken to general floor. Has your vocal cords get stonger this will completely go away with time. Using body mass index to predict optimal thyroid dosing after thyroidectomy, Thyroid Hormone Replacement in Patients Following Thyroidectomy for Thyroid Cancer. The only thing he noted was there was a bit of thick mucus that was just above the uvula in my throat. In the weeks after your thyroid surgery, you may have neck pain, soreness of your vocal chords or a weak . I also had issues with choking on liquids & foods after my TT in 2013. I found breathing through them helps a lot. A smaller less vascular mass with a maximum diameter of 1.2 cm it is posterior to the dominant mass in the left lobe. National Library of Medicine 2022 Sep;279(9):4213-4227. doi: 10.1007/s00405-022-07386-8. RAI could cause the salivary glands to not produce enough saliva or cause a stone that would block the flow. What Is Thyroidectomy And Why Is It Performed? Sorry in admvance. The liquid form in two presentationsa soft gel capsule and as an oral solutionrecently became available for LT4 replacement therapy (10). Some people with dysphagia have problems swallowing certain foods or liquids, while others can't swallow at all. Methods: and Zaborek et al. Although significantly more patients found the tablet form more agreeable, subjective symptoms had decreased significantly at the end of the study, and 73% of patients requested to remain on the liquid formulation (29). Federal government websites often end in .gov or .mil. Ulcerative Colitis as a Novel Cause of Increased Need for Levothyroxine, Novel thyroxine formulations: a further step toward precision medicine. Help. Rehabilitation of Post-Stroke Swallowing Dysfunction with Repeated Transcranial Magnetic Stimulation RTMS Based on Tomographic Images. After a while, it goes away. Cappelli C, Pirola I, Gandossi E, Cristiano A, Daffini L, Agosti B, et al. Choking feeling/tightness after thyroidectomy. Post-thyroidectomy voice and swallowing disorders and association with laryngopharyngeal reflux: A scoping review. Have you tried tucking your chin when you swallow? As reported by Del Duca et al. Epub 2022 Apr 19. The most common ones that lead to the necessity of LT4 dose adjustments include lack of compliance, changes in LT4 formulation, dosage errors, increased serum levels of T4-binding globulin, body mass changes, and dietary habits. Hey - i realise this question was asked about a year ago, butwell, at least the first respondent's answer suggests to me that there's an issue w/ salivation, leading to a dry mouth and throat. The .gov means its official. Lesson learned. I definitely went through this as well; including coughing so badly I would vomit. Finally, patients included in the ATA low-risk category, with undetectable thyroglobulin, should maintain a TSH level between 0.5 and 2 mU/L, whereas the level decreases to 0.10.5 mU/L if the thyroglobulin is low. Disclaimer. Similarly, Cappelli et al. 10 months on I have had swallowing problems to extent that sometimes I choke and vomit. TSH levels were significantly lower in patients treated with liquid LT4, suggesting a higher absorption with this formulation (12). ThyCa: Thyroid Cancer Survivors' Association, Inc. 14 year Because so many doctors like to believe that a TSH test is all they need to diagnose and treat hypothyroidism, many hypothyroid patients never feel normal again unless they are treated clinically. Beyond the classic tablet form, new formulations of LT4, such as a soft gel capsule and an oral solution, recently became available. Thyroidectomy is the most commonly performed surgical procedure on endocrine glands and its effect on swallowing is common, following both complicated and uncomplicated surgery [1,2,3].Swallowing disorders after a recurrent laryngeal nerve injury are expected, because of the movement dysfunction caused on the larynx, and the damage of the superior laryngeal nerve can affect the sensory . no resolutions yet. over a year ago, Guest Administration of the optimal dose of levothyroxine (LT4) is crucial to restore euthyroidism after total thyroidectomy. I count my lucky stars i proved the docs wrong but I'm also lucky in that my voice came back strong after a few days and the stiffness didn't get chance to get stiff i believe largely due to all the choking i did the the first few days. A remarkable improvement was obtained when schemes using BMI were introduced. Esophageal motility changes after thyroidectomy; possible associations with postoperative voice and swallowing disorders: preliminary results. A total or near-total thyroidectomy is the surgical removal of all or most of your thyroid tissue. It's to the point that it's second nature. When I would choke the only option was to bring it up and when it did I noticed most of it was mucus. A study by Peirce et al. An official website of the United States government. Symptoms after thyroid surgery may include dysphagia, dysphonia, aspiration, choking, and even dyspnea (10) (11) (12)(13). I have found over the last 2 months this has improved little by little by doing exercise like pull ups, press ups and tensing my throat to exercise the muscles, in the short termit still feels the same but after a few hours it seems to relax and improve and sometimes I can go a few days with very minimal symptoms. 2020 Jun;59(Suppl 1):38-49. doi: 10.20471/acc.2020.59.s1.05. Every doctor I mentioned it to thought I was crazy. Their study found that the liquid formulation resulted in a significantly greater efficacy in ameliorating these parameters. I was diagnosed with a large tumor - a follicular neoplasm - on Feb. 19th after a biopsy was done. But I'd still love a perfect steak meal right now! Twenty articles were selected for inclusion in the review. I had a complete Thyroidectomy nearly 3 years ago (2 days before you to be exact!). The coughing has just stopped. Clipboard, Search History, and several other advanced features are temporarily unavailable. Oral L-thyroxine liquid versus tablet in patients submitted to total thyroidectomy for thyroid cancer (without malabsorption): A prospective study. In this study of a retrospective cohort of 598 patients, their scheme outperformed the other previously proposed schemes, predicting 64.8% of the corrected doses at the first follow-up. Wanda was resigned to eating soft foods as she typically could not finish a meal without choking. Our literature review resulted in eight papers dealing with the administration of a liquid or soft gel capsule formulation in patients who underwent total thyroidectomy. 7 years on I'm mostly tube free but when i get a throat infection i need 24 - 36 hours of NG tube fluids to keep me out of hospital and the same if i get a bug - the vomiting sends my swallowing out of sync. The authors reported that the TSH level was lower with the liquid LT4 compared with tablet LT4 form, concluding that liquid LT4 is resistant to the sequestration by calcium or iron.
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